| Entity Name: | COASTAL REHABILITATION SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 30 May 1986 (39 years ago) |
| Date of dissolution: | 19 Apr 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Apr 2021 (4 years ago) |
| Document Number: | M32919 |
| FEI/EIN Number | 59-2705377 |
| Address: | 3395 N Oceanshore Blvd.,, Flagler Beach, FL 32136 |
| Mail Address: | 65 KINGFISHER LANE, PALM COAST, FL 32137 |
| ZIP code: | 32136 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083672505 | 2006-05-03 | 2020-08-22 | 1717 N. FLAGLER DR, #8, WEST PALM BEACH, FL, 33407, US | 1717 N FLAGLER DR, WEST PALM BEACH, FL, 334076555, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-655-2222 |
| Fax | 5616595240 |
Authorized person
| Name | DR. PADGETT MILLER |
| Role | PRESIDENT |
| Phone | 5616552222 |
Taxonomy
| Taxonomy Code | 171100000X - Acupuncturist |
| License Number | AP 1550 & AP 1551 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| License Number | PT 2467 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BC BS FL |
| Number | Y035P |
| State | FL |
| Issuer | BC BS FL |
| Number | C0908 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Padgett, MILLER | Agent | 3395 N Oceanshore Blvd.,, FLAGLER BEACH, FL 32136 |
| Name | Role | Address |
|---|---|---|
| MILLER, PADGETT | President | 3395 N Oceanshore Blvd.,, Flagler Beach, FL 32136 |
| Name | Role | Address |
|---|---|---|
| Padgett Miller | Executive Secretary | 3395, N Ocean Shore Blvd. Flagler Beach, FL 32136 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-04-19 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2020-10-09 | 3395 N Oceanshore Blvd.,, Flagler Beach, FL 32136 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-02-27 | Padgett, MILLER | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-12 | 3395 N Oceanshore Blvd.,, Flagler Beach, FL 32136 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-12 | 3395 N Oceanshore Blvd.,, FLAGLER BEACH, FL 32136 | No data |
| REINSTATEMENT | 1989-01-19 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1987-11-16 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-04-19 |
| ANNUAL REPORT | 2020-02-27 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-10 |
| ANNUAL REPORT | 2016-03-16 |
| ANNUAL REPORT | 2015-02-12 |
| ANNUAL REPORT | 2014-01-09 |
| ANNUAL REPORT | 2013-01-25 |
| ANNUAL REPORT | 2012-02-08 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
